Predictive Factors for Early Immune Recovery in NHL Patients after Autologous Transplantation: A Multicenter Prospective Study

Affiliations
  • 1Department of Medicine, Kuopio University Hospital, 70290 Kuopio, Finland.
  • 2Institute of Clinical Medicine, University of Eastern Finland, 70211 Kuopio, Finland.
  • 3Department of Oncology, Kuopio University Hospital, 70290 Kuopio, Finland.
  • 4Cancer Center, Oulu University Hospital, 90220 Oulu, Finland.
  • 5Eastern Finland Laboratory Centre, 70211 Kuopio, Finland.
  • 6Department of Medicine, Kymenlaakso Central Hospital, 48210 Kotka, Finland.

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Abstract

Early lymphocyte recovery as manifested by an absolute lymphocyte count at d+15 (ALC-15) ≥ 0.5 × 10/L after autologous hematopoietic stem cell transplantation (AHCT) has been associated with a better outcome. This prospective multicenter study aimed to clarify factors associated with ALC-15 ≥ 0.5 × 10/L after AHCT among 178 patients with non-Hodgkin lymphoma. The mobilization capacity, as manifested by peak blood CD34 cell numbers > 45 × 10/L correlated with higher ALC-15 levels ( = 0.020). In addition, the amount of CD3CD4 T cells > 31.8 × 10/kg in the infused graft predicted ALC-15 ≥ 0.5 × 10/L ( 28.8 × 10/kg ( = 0.017) and NK cells > 4.4 × 10/kg was linked with higher ALC-15 ( < 0.001). The two-year progression-free survival after AHCT was significantly better in patients with ALC-15 ≥ 0.5 × 10/L (74 vs. 57%, = 0.027). The five-year OS in patients with higher ALC-15 was 78% vs. 60% in those with lower ALC-15 ( = 0.136). To conclude, the mobilization capacity of CD34 cells and detailed measures of graft cellular content mark prognostic tools that predict ALC-15 ≥ 0.5 × 10/L, which is associated with a better outcome in NHL patients after AHCT.